Short- and long-term effects of beta-blockers on symptoms of anxiety and depression in patients with myocardial infarction and preserved left ventricular function : a pre-specified quality of life sub-study from the REDUCE-AMI trial
(2024) In European Heart Journal: Acute Cardiovascular Care 13(11). p.789-797- Abstract
Aims: Among patients with myocardial infarction (MI) with preserved left ventricular ejection fraction (LVEF), the REDUCE-AMI trial did not demonstrate a benefit of beta-blocker vs. no beta-blocker treatment on all-cause mortality and recurrent myocardial infarction. The aim of this pre-specified sub-study was to investigate effects of beta-blockers on self-reported symptoms of anxiety and depression. Methods and results: In this parallel-group, open-label, registry-based randomized trial, assessments with the Hospital Anxiety and Depression Scale were obtained at hospitalization and two follow-up points (6-10 weeks and 12-14 months) after MI. Analyses were based on the intention-to-treat principle using linear mixed models, calculating... (More)
Aims: Among patients with myocardial infarction (MI) with preserved left ventricular ejection fraction (LVEF), the REDUCE-AMI trial did not demonstrate a benefit of beta-blocker vs. no beta-blocker treatment on all-cause mortality and recurrent myocardial infarction. The aim of this pre-specified sub-study was to investigate effects of beta-blockers on self-reported symptoms of anxiety and depression. Methods and results: In this parallel-group, open-label, registry-based randomized trial, assessments with the Hospital Anxiety and Depression Scale were obtained at hospitalization and two follow-up points (6-10 weeks and 12-14 months) after MI. Analyses were based on the intention-to-treat principle using linear mixed models, calculating both short- and long-term effects. From August 2018 through June 2022, 806 patients were enrolled. At baseline, 27% of patients were possible cases of anxiety (m, 5.6; SD, 3.9) and 14% were possible cases of depression (m, 3.9; SD, 3.2). Beta-blocker treatment had a negative effect on depressive symptoms at both follow-ups 1 (β = 0.48; 95% CI 09-0.86; P = 0.015) and 2 (β = 0.41; 95% CI = 0.01-0.81; P = 0.047), but no effect on anxiety. Conclusion: Beta-blocker treatment led to a modest increase in depressive symptoms among MI patients with preserved LVEF. This observed effect was most pronounced in individuals with prior beta-blocker treatment. In routine initiation and continuation of beta-blocker treatment, a risk of slightly increased depressive symptoms should be considered.
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- author
- Leissner, Philip ; Mars, Katarina ; Humphries, Sophia ; Karlström, Patric ; Yndigegn, Troels LU ; Jernberg, Tomas ; Hofmann, Robin ; Held, Claes and Olsson, Erik M.G.
- organization
- publishing date
- 2024-11
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Anxiety, Beta-blocker, Depression, Linear mixed models, Psychological distress, Treatment
- in
- European Heart Journal: Acute Cardiovascular Care
- volume
- 13
- issue
- 11
- pages
- 9 pages
- publisher
- Oxford University Press
- external identifiers
-
- pmid:39422765
- scopus:85212760815
- ISSN
- 2048-8726
- DOI
- 10.1093/ehjacc/zuae112
- language
- English
- LU publication?
- yes
- id
- fd5a4c86-a2ad-489c-a523-e4e4f3793962
- date added to LUP
- 2025-01-22 10:46:45
- date last changed
- 2025-07-10 00:29:32
@article{fd5a4c86-a2ad-489c-a523-e4e4f3793962,
abstract = {{<p>Aims: Among patients with myocardial infarction (MI) with preserved left ventricular ejection fraction (LVEF), the REDUCE-AMI trial did not demonstrate a benefit of beta-blocker vs. no beta-blocker treatment on all-cause mortality and recurrent myocardial infarction. The aim of this pre-specified sub-study was to investigate effects of beta-blockers on self-reported symptoms of anxiety and depression. Methods and results: In this parallel-group, open-label, registry-based randomized trial, assessments with the Hospital Anxiety and Depression Scale were obtained at hospitalization and two follow-up points (6-10 weeks and 12-14 months) after MI. Analyses were based on the intention-to-treat principle using linear mixed models, calculating both short- and long-term effects. From August 2018 through June 2022, 806 patients were enrolled. At baseline, 27% of patients were possible cases of anxiety (m, 5.6; SD, 3.9) and 14% were possible cases of depression (m, 3.9; SD, 3.2). Beta-blocker treatment had a negative effect on depressive symptoms at both follow-ups 1 (β = 0.48; 95% CI 09-0.86; P = 0.015) and 2 (β = 0.41; 95% CI = 0.01-0.81; P = 0.047), but no effect on anxiety. Conclusion: Beta-blocker treatment led to a modest increase in depressive symptoms among MI patients with preserved LVEF. This observed effect was most pronounced in individuals with prior beta-blocker treatment. In routine initiation and continuation of beta-blocker treatment, a risk of slightly increased depressive symptoms should be considered.</p>}},
author = {{Leissner, Philip and Mars, Katarina and Humphries, Sophia and Karlström, Patric and Yndigegn, Troels and Jernberg, Tomas and Hofmann, Robin and Held, Claes and Olsson, Erik M.G.}},
issn = {{2048-8726}},
keywords = {{Anxiety; Beta-blocker; Depression; Linear mixed models; Psychological distress; Treatment}},
language = {{eng}},
number = {{11}},
pages = {{789--797}},
publisher = {{Oxford University Press}},
series = {{European Heart Journal: Acute Cardiovascular Care}},
title = {{Short- and long-term effects of beta-blockers on symptoms of anxiety and depression in patients with myocardial infarction and preserved left ventricular function : a pre-specified quality of life sub-study from the REDUCE-AMI trial}},
url = {{http://dx.doi.org/10.1093/ehjacc/zuae112}},
doi = {{10.1093/ehjacc/zuae112}},
volume = {{13}},
year = {{2024}},
}